Effect of a governmentally-led physical activity program on motor skills in young children attending child care centers: a cluster randomized controlled trial

Abstract

Objective: To assess the effect of a governmentally-led center based child care physical activity program (Youp'là Bouge) on child motor skills.

Patients and methods: We conducted a single blinded cluster randomized controlled trial in 58 Swiss child care centers. Centers were randomly selected and 1:1 assigned to a control or intervention group. The intervention lasted from September 2009 to June 2010 and included training of the educators, adaptation of the child care built environment, parental involvement and daily physical activity. Motor skill was the primary outcome and body mass index (BMI), physical activity and quality of life secondary outcomes. The intervention implementation was also assessed.

Results: At baseline, 648 children present on the motor test day were included (age 3.3 ± 0.6, BMI 16.3 ± 1.3 kg/m2, 13.2% overweight, 49% girls) and 313 received the intervention. Relative to children in the control group (n = 201), children in the intervention group (n = 187) showed no significant increase in motor skills (delta of mean change (95% confidence interval: -0.2 (-0.8 to 0.3), p = 0.43) or in any of the secondary outcomes. Not all child care centers implemented all the intervention components. Within the intervention group, several predictors were positively associated with trial outcomes: (1) free-access to a movement space and parental information session for motor skills (2) highly motivated and trained educators for BMI (3) free-access to a movement space and purchase of mobile equipment for physical activity (all p < 0.05).

Conclusion: This "real-life" physical activity program in child care centers confirms the complexity of implementing an intervention outside a study setting and identified potentially relevant predictors that could improve future programs.

Trial registration: Clinical trials.gov NCT00967460.

Figure 1

Trial profile of clusters. INT = Intervention child care centers, CON = Child care centers. All public child care centers in the three cantons were eligible to participate in the program. No precise information was given concerning the nature of the two withdrawals.

Figure 2

Description of the obstacle courses. 1) Running 2) Climbing up and down the stairs 3) Balancing 4) Getting up 5) Landing after jumping.

Figure 3

Trial profile of participants. ¹Due to a mean attendance of the children at child care of 48%, 648 children were present on the test day at baseline, 589 with valid BMI and 533 with valid motor skill (global motor score) measures. ²Valid data for total quality of life as assessed by PedsQL questionnaire. ³Due to cost and logistic reasons, 30 of the 58 child care centers were randomly selected to also include physical activity measurements which were performed one week after the other outcomes.